The impact of diabetes during pregnancy on neonatal outcomes among the Aboriginal population in Western Australia : a whole-population study

dc.contributor.authorAhmed, Marwan Awad
dc.contributor.authorBailey, Helen D.
dc.contributor.authorPereira, Gavin
dc.contributor.authorWhite, Scott W.
dc.contributor.authorWong, Kingsley
dc.contributor.authorMcNamara, Bridgette J.
dc.contributor.authorRheeder, Paul
dc.contributor.authorMarriott, Rhonda
dc.contributor.authorShepherd, Carrington C.J.
dc.date.accessioned2024-06-24T09:32:30Z
dc.date.available2024-06-24T09:32:30Z
dc.date.issued2023-10
dc.descriptionDATA AVAILABILITY : The datasets underlying this article were provided by the WA Data Linkage Branch. To access these datasets, researchers should refer to the Data Linkage Branch of the Western Australia Government Department of Health (www.datalinkage-wa.org.au).en_US
dc.description.abstractBACKGROUND : Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have a high prevalence of diabetes in pregnancy (DIP), which includes pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). We aimed to characterize the impact of DIP in babies born to Aboriginal mothers. METHODS : A retrospective cohort study, using routinely collected linked health data that included all singleton births (N = 510 761) in Western Australia between 1998 and 2015. Stratified by Aboriginal status, generalized linear mixed models quantified the impact of DIP on neonatal outcomes, estimating relative risks (RRs) with 95% CIs. Ratio of RRs (RRRs) examined whether RRs differed between Aboriginal and non-Aboriginal populations. RESULTS : Exposure to DIP increased the risk of adverse outcomes to a greater extent in Aboriginal babies. PGDM heightened the risk of large for gestational age (LGA) (RR: 4.10, 95% CI: 3.56–4.72; RRR: 1.25, 95% CI: 1.09–1.43), macrosomia (RR: 2.03, 95% CI: 1.67–2.48; RRR: 1.39, 95% CI: 1.14–1.69), shoulder dystocia (RR: 4.51, 95% CI: 3.14–6.49; RRR: 2.19, 95% CI: 1.44–3.33) and major congenital anomalies (RR: 2.14, 95% CI: 1.68–2.74; RRR: 1.62, 95% CI: 1.24–2.10). GDM increased the risk of LGA (RR: 2.63, 95% CI: 2.36–2.94; RRR: 2.00, 95% CI: 1.80–2.22), macrosomia (RR: 1.95, 95% CI: 1.72–2.21; RRR: 2.27, 95% CI: 2.01–2.56) and shoulder dystocia (RR: 2.78, 95% CI: 2.12–3.63; RRR: 2.11, 95% CI: 1.61–2.77). Birthweight mediated about half of the DIP effect on shoulder dystocia only in the Aboriginal babies. CONCLUSIONS : DIP differentially increased the risks of fetal overgrowth, shoulder dystocia and congenital anomalies in Aboriginal babies. Improving care for Aboriginal women with diabetes and further research on preventing shoulder dystocia among these women can reduce the disparities.en_US
dc.description.departmentInternal Medicineen_US
dc.description.librarianhj2024en_US
dc.description.sdgSDG-03:Good heatlh and well-beingen_US
dc.description.sponsorshipUniversity of Western Australia, Australian Government Research Training Program Scholarship, the Peter and Anne Hector Award, Australian National Health and Medical Council, WA Health and Artificial Intelligence Consortium, the Research Council of Norway.en_US
dc.description.urihttps://academic.oup.com/ijeen_US
dc.identifier.citationMarwan Awad Ahmed, Helen D. Bailey, Gavin Pereira, Scott W. White, Kingsley Wong, Bridgette J. McNamara, Paul Rheeder, Rhonda Marriott, Carrington C.J. Shepherd, The impact of diabetes during pregnancy on neonatal outcomes among the Aboriginal population in Western Australia: a whole-population study, International Journal of Epidemiology, Volume 52, Issue 5, October 2023, Pages 1400–1413, https://doi.org/10.1093/ije/dyad072.en_US
dc.identifier.issn0300-5771 (print)
dc.identifier.issn1464-3685 (online)
dc.identifier.other10.1093/ije/dyad072
dc.identifier.urihttp://hdl.handle.net/2263/96600
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.rights© The Author(s) 2023; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.en_US
dc.subjectDiabetes in pregnancy (DIP)en_US
dc.subjectPre-gestational diabetes mellitus (PGDM)en_US
dc.subjectGestational diabetes mellitus (GDM)en_US
dc.subjectTorres Strait Islanderen_US
dc.subjectAboriginalen_US
dc.subjectWomenen_US
dc.subjectIndigenous Australiansen_US
dc.subjectNeonatal outcomesen_US
dc.subjectSDG-03: Good health and well-beingen_US
dc.titleThe impact of diabetes during pregnancy on neonatal outcomes among the Aboriginal population in Western Australia : a whole-population studyen_US
dc.typePostprint Articleen_US

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